The Ultra-Processed Myth

Position paper on the growing interest in a newly-popularised idea in health and nutrition: ‘ultra-processed foods’

November 2023

Just as natural foods are not necessarily healthy, processed foods are not necessarily unhealthy” – Chris Bryant

1. What are ‘Ultra-Processed Foods’?

Recent months have seen growing interest in a newly-popularised idea in health and nutrition: ‘ultra-processed foods’.

The term refers to foods which fall in Category 4 of the NOVA classification system, and the public appears to have become increasingly wary of such foods in terms of their healthiness. While it is true that higher consumption of ultra-processed foods has been linked to worse health outcomes on average in epidemiological studies, this categorisation poses at least three problems.

First, the definition of the ‘ultra-processed’ category is not clear to consumers. Only 40% of consumers understand what ultra-processed means, and consumers are unable to accurately identify most ultra-processed foods when tested. Moreover, there is very low consistency between people when it comes to categorising foods as ultra-processed. This creates confusion and renders the system difficult to apply in practice.

Second, there is substantial disagreement and criticism of the system within food scienceCriticism of the NOVA classification system highlights ‘major inconsistencies and mistakes’. As one criticism puts it:

“On the one hand, “yogurt with no added sugar or artificial sweeteners” is specifically cited as an example of a NOVA1 food. On the other hand, it is clearly stated that non-alcoholic fermentation, the process by which yogurt is made (i.e., lactic fermentation), is characteristic of NOVA3 foods. It is further mentioned that “substances […], such as casein, lactose, whey”—ingredients often present in yogurt—are “only found in ultra-processed products,” meaning NOVA4 foods.”

Similar examples of this kind of contradiction and inconsistency in the NOVA system abound, leading many food scientists to question its foundational approach.

Third, any time we categorise food into groups, we risk sweeping generalisations. Foods in the same group are then assumed to be equally good or equally bad, even though foods within a group can be very diverse. For example, we know that men are, on average, taller than women – but we all understand that this doesn’t mean that all men are taller than all women. Analogously, even if it is true that ultra-processed foods are less healthy on average, it can also be true that some foods which happen to fall into the ultra-processed category are, in fact, very healthy – such as wholegrain bread and fortified cereals.

The NOVA classification operates on the degree of food processing rather than specific nutritional content. This means that foods with a similar degree of processing, but with vastly different nutritional profiles may be grouped together, leading to oversimplifications. Categorising foods according to their degree of processing is not an informative way to analyse their healthiness when we have better data available. We can analyse the healthiness of foods directly based on their nutritional contents. Moreover, categorising foods according to this framework is the subject of public confusion and scientific contention, yielding this framework inconsistent.

2. Where Did This Idea Come From?

The research underpinning the idea of ultra-processed foods is largely attributable to a research group at the University of São Paulo in Brazil. The name ‘NOVA’ is not an acronym –  ‘nova’ simply means ‘new’ in Portuguese. Early iterations of the NOVA classification system identified three categories of processing (2009, 2010), but the current iteration (2019) has four categories. Although the system is published by the Food and Agriculture Organization (FAO), the organisation notes that ‘The views expressed in this information product are those of the author(s) and do not necessarily reflect the views or policies of FAO, nor do they constitute a validation of the NOVA classification system.’ 

The idea of ultra-processed foods has become particularly popular in the last year – Google Trends indicates a consistent rise in search activity starting around summer 2022. A year later, Dr Chris van Tulleken published the book ‘Ultra-Processed People’, which further solidified this concept in the public imagination. But the popularisation of this idea can be traced back further than that.

In 2019, full-page adverts appeared in the Washington Post and the New York Times attacking plant-based meats as having too many ingredients and being ‘highly processed’. In 2020, an advert ran at the Super Bowl making the same attack on plant-based meat.

The lobbying group behind the adverts was the Center for Consumer Freedom, which lobbies for the meat, alcohol, and tobacco industries. It is an open secret: the idea of plant-based meat being processed, and therefore unhealthy, has been actively promoted by the meat industry.

3. A Misleading Heuristic

The idea that ultra-processed foods are unhealthy has also been able to spread quickly because it feels true. ‘Natural = healthier’ seems like a very intuitive heuristic to most people. However, on closer examination, this is obviously not always the case. Clearly, there are foods which occur in nature that are not healthy for humans: wandering into your nearest woodland and wolfing down unknown mushrooms and berries, safe in the knowledge that they are natural, would be ill-advised. 

Just as natural foods are not necessarily healthy, processed foods are not necessarily unhealthy.

Just as natural foods are not necessarily healthy, processed foods are not necessarily unhealthy. Indeed, some things which would be classified as ultra-processed are recommended for optimal health (such as vitamin D pills), while others are downright necessary (such as baby formula). In a stark demonstration of just how misguided this heuristic can be, scientists at the United States Department of Agriculture (USDA) devised a healthy and nutritionally complete diet which was composed of 91% ultra-processed foods. This misguided heuristic becomes particularly evident when looking at the recent treatment of a specific food type: plant-based meats.

4. Plant Based Meat Alternatives

A survey by the British Nutrition Foundation asked consumers to name ultra-processed foods, and found that one of the most frequently mentioned foods was plant-based meat (second only behind ready meals). While this perception has been deliberately planted by meat industry lobbyists,  32% of the animal meat consumed in the UK is processed.

Moreover, many of the specific reasons given why ultra-processed foods are unhealthy do not apply to plant-based meats! While ultra-processed foods are criticised for their high calorie density and low hunger satiety, evidence suggests that compared to meat from animals, plant-based meat has lower calorie density, and higher hunger satiety!

Indeed, the Physicians Association for Nutrition has highlighted that plant-based meats are often ‘grouped with notoriously unhealthy products such as chocolate snacks, fast foods and sugary drinks’, which makes it ‘difficult to make solid conclusions about the healthiness of plant-based meat products based on the NOVA classification’. 

In fact, a review of studies comparing the healthiness of plant-based vs. animal meat found that plant-based meat products tend to be lower in saturated fat, lower in cholesterol, and higher in fibre. A randomised control trial found that plant-based meat consumption was associated with lower risk of heart disease as a result.

5. The Turning Tide

Fortunately, there is more and more evidence that the tide is turning on the idea of ultra-processed foods. Increasingly, authoritative nutritional organisations and experts are recognising that this categorisation can be uninformative, or even downright misleading.

The British Dietetic Association has criticised the concept of ultra-processed foods as ‘overly broad and ill-defined’. The British Nutrition Foundation’s position on ultra-processed foods argues that ‘due to the lack of agreed definition, the need for better understanding of mechanisms involved and concern about its usefulness as a tool to identify healthier products, the concept of UPF does not warrant inclusion within policy (e.g. national dietary guidelines).’

The Scientific Advisory Committee on Nutrition highlights ‘limitations in the NOVA classification system’ including ‘the potential for confounding’, concluding that ‘the evidence to date needs to be treated with caution’. Professor Robin May, the Chief Scientific Advisor to the UK’s Food Standards Agency, has said that we are ‘in danger of throwing the baby out with the bathwater’ when it comes to healthy processed foods like sweeteners, whole grain bread, and fortified cereals.

The scientific institutions which matter are beginning to recognise that ultra-processed foods are not necessarily unhealthy, and in many cases, they can be an essential part of healthy diets. It is essential for consumers to be well-informed and look beyond broad categorisations and heuristics when assessing foods’ healthiness.

In particular, replacing animal meat with plant-based meat alternatives may mean eating more processed foods, but it also means cutting down on calories, cutting down on saturated fat, and boosting intake of fibre.

When it comes to meat and meat alternatives, less processed does not necessarily mean healthier.